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No one knows exactly what causes psoriasis, but people with this autoimmune disease have different triggers that may cause symptom flare-ups. By tracking when you experience psoriasis symptoms, you can identify your triggers.

"Psoriasis triggers don't cause the disease, but they can activate it," says Danielle M. Miller, MD, a dermatologist in Burlington, Massachusetts. Understanding common psoriasis triggers also helps doctors and patients form strategies for treatment and management.

Skin Injuries and Flares

An injury to the skin can cause a psoriasis flare. "People with psoriasis will often develop symptoms at the site of skin trauma,” Dr. Miller says. “This could be in an area where they have had surgery, or where they have had an infection. This may also explain why psoriasis tends to form on elbows and knees, as these are areas of the body that are exposed to more hard use." Other types of skin injury that may trigger psoriasis symptoms include vaccinations, sunburns, and even insect bites.

Skin care is an important part of psoriasis treatment. "That means moisturizing well every day,” says Miller. It's best to use an oil-based ointment or cream instead of a water-based lotion. Apply moisturizer immediately after a bath or shower, and keep moisturizing during the day. Moisturizing an affected skin area and keeping it covered with a plastic wrap overnight can also help.

Light as Therapy

Cold winter weather seems to be a psoriasis trigger for some people. "Psoriasis does seem to get worse in the winter and better in the summer, but it's hard to know how much of this is due to dryness in the winter and how much is due to lack of sunlight,” says Miller. Increased humidity in the summer may be a positive factor, but studies also show that some sun exposure is good for psoriasis.

"Using a humidifier at home or at work in the winter may help a little, but what may be even better is getting some exposure to UVB [ultraviolet light B]," says Miller.

UVB is a type of light that is present in natural sunlight, and has been shown to be an effective psoriasis treatment. "Narrow band UVB can help 80 percent of people with psoriasis, and when it’s used in a controlled setting, it is much safer than a tanning booth," says Miller. Ask your dermatologist about a UVB light box for psoriasis treatment.

The Stress Factor

"We don't know the exact reason, but stress is a psoriasis trigger for some people. Stress increases the body's inflammatory response, and it can also make other skin conditions worse,” says Miller. “A stressful trigger could be in the form of a move, a breakup, or the loss of a job. And, of course, psoriasis itself is stressful." As a result, stress and psoriasis symptoms can fuel each other: Psoriasis is a chronic disease that causes stress, and stress makes psoriasis worse.

You can help reduce stress by learning stress management techniques, such as meditation or yoga, and getting regular exercise. You can also get help from a strong support system of friends and family members. In addition, many people benefit from psoriasis support groups. "People with psoriasis often hide their condition from others. Joining a support group helps them understand that their disease is not that uncommon and that they are not alone," says Miller.

Smoking and Drinking

"Both alcohol and smoking are common triggers for psoriasis symptoms and can make psoriasis treatment harder," notes Miller. An occasional glass of wine probably won't hurt you, but heavy use of any alcohol has been shown to trigger the body's inflammatory response. In addition, a review published in January 2012 in the American Journal of Epidemiology found that active smokers are more likely to have psoriasis than nonsmokers.

Taking steps to live a healthy lifestyle can help you manage psoriasis, as well as improve your overall health. Getting plenty of rest and regular exercise are both important as they help you maintain a healthy immune system and avoid flare-ups, especially those triggered by illness.

A review published in September 2014 in JAMA Dermatology that examined the results of 15 trials on the benefits of omega-3 fatty acids in fish oil for treating psoriasis indicated mix results. The researchers found some outcomes showed that fish oil given to participants in both large and small amounts gave them the most benefit, improving erythema (redness), induration (thickness), and scaling in both plaque and guttate psorarisis. But other results did not mark improvement. Overall the researchers cited moderate benefit for the use of fish oil supplements in psoriasis.

Effects of Medication

Medication is a common psoriasis trigger. Treatments that can trigger psoriasis symptoms include beta-blockers that may be used for heart disease, lithium to treat some psychiatric disorders, and several drugs for malaria.

"Steroid medications like cortisone work well as psoriasis treatments topically. But systemic cortisone — a steroid taken by mouth — can trigger a flare of psoriasis symptoms when the medication is stopped," says Miller. Be sure to check with your prescribing doctor and dermatologist before changing or discontinuing any culprit medication.

Identifying and avoiding your triggers, keeping your immune system healthy by reducing stress, avoiding illness, and maintaining a healthy lifestyle are the best ways to keep psoriasis under control. Learn as much as you can about the disease, work closely with your doctor, and stick to your psoriasis treatment plan.